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1.
Björn Gjelvold Deyar Jallal Hadi Mahmood Ann Wennerberg 《The Journal of prosthetic dentistry》2019,121(3):498-503
Statement of problem
Different factors influence the degree of deviation in dental implant position after computed tomography–guided surgery. The surgical guide–manufacturing process with desktop 3D printers is such a factor, but its accuracy has not been fully evaluated.Purpose
The purpose of this in vitro study was to evaluate the deviation in final dental implant position after the use of surgical guides fabricated from 2 different desktop 3D printers using a digital workflow.Material and methods
Twenty 3D-printed resin models were prepared with missing maxillary premolar. After preoperative planning, 10 surgical guides were produced with a stereolithography printer and 10 with a digital light-processing (DLP) printer. A guided surgery was performed; 20 dental implants (3.8×12 mm) were installed, and a digital scan of the dental implants was made. Deviations between the planned and final position of the dental implants were evaluated for both the groups.Results
A statistically significant difference between stereolithography and DLP were found for deviation at entry point (P=.023) and the vertical implant position (P=.009). Overall lower deviations were found for the guides from the DLP printer, with the exception of deviation in horizontal implant position.Conclusions
The tested desktop 3D printers were able to produce surgical guides with similar deviations with regard to the final dental implant position, but the DLP printer proved more accurate concerning deviations at entry point and vertical implant position. 相似文献2.
Alexander R. Edelmann Devang Patel Riley K. Allen Chad J. Gibson Al M. Best Sompop Bencharit 《The Journal of prosthetic dentistry》2019,121(3):404-410
Statement of problem
The design of porous tantalum trabecular metal–enhanced titanium (TM) dental implants promises improved osseointegration, especially when grafting materials such as demineralized bone matrix are used; however, studies are lacking.Purpose
The purpose of this retrospective study was to compare TM implants with conventional titanium alloy (Ti) implants with and without demineralized bone matrix in terms of peri-implant bone remodeling in the first year after implant loading.Material and methods
A chart review was used for all patients receiving Tapered Screw-Vent Ti and TM implants. Implants were placed and restored by a single provider between 2011 and 2015. Peri-implant bone remodeling was compared by using a paired t test (α=.05).Results
A total of 82 patients received 205 implants, 44 TM and 161 Ti implants (control). No implants failed in the TM group (survival rate of 100%), and 3 implants in total, 1 immediate, failed in the Ti groups (survival rate of 98.1%). TM implants exhibited a 0.28-mm bone gain on average, whereas the control group demonstrated 0.20 mm of marginal bone loss after the first year of implant loading. Multivariate logistic regression analysis demonstrated that the odds of having bone loss was 64% less (odds ratio: 0.36; 95% confidence interval: 0.14-0.94) in the TM group than in the Ti group after controlling for bone grafting, implant location, immediate placement, bone type, and pretreatment bone level.Conclusions
TM implants exhibited less peri-implant bone loss than the control Ti implants. 相似文献3.
Yiqin Fang Xueyin An Seung-Mi Jeong Byung-Ho Choi 《The Journal of prosthetic dentistry》2019,121(5):836-842
Statement of problem
Implant placement in the anterior regions is often challenging because of limited space and bone volume availability.Purpose
The purpose of this clinical study was to investigate the accuracy of computer-guided surgery with a long drill key to place implants in the anterior regions.Material and methods
Computer-guided implant surgery was performed for 32 participants requiring implants in anterior regions. The procedure involved using a 12-mm-long drill key to guide the 2.0-mm-diameter drill. Deviations between the planned and actual implant positions were evaluated by using cone beam computed tomography (CBCT) scans obtained before and after surgery. A t test was used for comparisons between the planned and placed implants and to determine the influence of the arch (maxilla/mandible) and time (immediate/delayed) on accuracy.Results
A total of 40 implants (20 implants in the maxilla and 20 implants in the mandible) were placed. The mean linear deviation was 0.46 mm (range, 0 to 1.15 mm) for the implant shoulder and 0.67 mm (range, 0.14 to 1.19 mm) for the implant apex. The mean angular deviation was 1.40 degrees (range, 0.30 to 2.57 degrees). The mean depth deviation was 0.15 mm (range, 0.10 to 0.82 mm).Conclusions
This clinical study showed that the accuracy of computer-guided implant placement may be enhanced by using a long drill key and may thus enable more accurate implant placement in anterior regions. 相似文献4.
Lisa A. Lang Sarah E. Hansen Norma Olvera Sorin Teich 《The Journal of prosthetic dentistry》2019,121(4):611-617
Statement of problem
Identifying factors that affect the clinical outcomes of implant therapy is important.Purpose
The purpose of this retrospective study was to determine whether implant location was a factor affecting the complication and failure rates of single-tooth implant-supported restorations in a predoctoral setting.Material and methods
The charts of 431 patients treated with a surgically placed dental implant and restored with a single crown in the predoctoral clinic were analyzed. Data on implant location, type of complication (surgical or prosthetic), and type of failure were collected and analyzed according to implant location using the Fisher Exact Test and Mantel-Haenszel Exact Chi Square Test analysis (α=.05).Results
The charts revealed 158 complications (68 surgical and 90 prosthetic) in 110 patients, and 3.9% of the implants failed. No statistically significant difference was found between the number of surgical complications or prosthetic complications in the maxilla and the mandible (P=.469).Conclusions
Jaw location (maxilla compared with mandible) of the implant had no statistically significant impact on the incidence of surgically or prosthetically related complications. No statistically significant difference was found in overall implant failures, surgical failures, and prosthetic failures between maxillary and mandibular implants. 相似文献5.
Daniel R. Reissmann Mike T. John Chris J. Enstad Patricia A. Lenton Ira Sierwald 《Journal of the American Dental Association (1939)》2019,150(4):278-286
Background
This study aimed to determine the psychometric properties of the English-language version of the Orofacial Esthetic Scale (OES-E) in a population of dental patients.Methods
In this cross-sectional study, 1,784 English-speaking, adult dental patients (mean age, 56.7 [standard deviation, 15.8] years; 60.0% women) were included. The 8-item OES-E was used to assess orofacial appearance. Dimensionality of the OES was investigated through an analysis of the items’ correlation matrix, a parallel analysis, and an exploratory factor analysis. Convergent validity was determined by means of several correlations between the OES and items of the Oral Health Impact Profile measuring orofacial appearance. Reliability of the OES was assessed as the instrument’s internal consistency by means of computing Cronbach α and average interitem correlation.Results
All analyses for dimensionality revealed that the OES is sufficiently represented by a single factor. Convergent validity was supported by means of the correlations of the OES summary score with the other measures of the construct with Pearson product moment and Spearman rank correlation coefficients of the expected size and direction. Cronbach α (lower boundary of 95% confidence interval, 0.94) and average interitem correlation (0.70) revealed that the scale’s internal consistency was excellent.Conclusion
This study found that the OES-E has sufficient psychometric properties to characterize dental patient’s global assessment of orofacial appearance.Practical Implications
The brevity and the easy application make the OES a pragmatic tool to clinically appraise the important construct of orofacial appearance in dental patients. 相似文献6.
7.
Carlo Maiorana Pier Paolo Poli Anna Mascellaro Susanna Ferrario Mario Beretta 《Journal of cranio-maxillo-facial surgery》2019,47(5):805-814
Purpose
To evaluate the long-term outcome of dental implants placed with a staged procedure in resorbed alveolar ridges reconstructed with iliac crest autogenous onlay grafts.Materials and methods
All consecutive patients treated with iliac crest onlay bone grafts and dental implants were retrospectively evaluated. During the appointment, clinical and radiological examinations were conducted to assess implant survival. A survived implant was defined as an implant still stable and in function at the follow-up visit. Implant survival was estimated at the implant level using Kaplan-Meier analyses. The cumulative survival rate was estimated using a life-table analysis. Subgroup analyses were performed for age, position, and type of retention using the log-rank test. A p-value of <0.05 was considered statistically significant.Results
The cohort consisted of 21 female subjects receiving a total of 140 rough-surface titanium implants. Of them, 128 survived and 12 failed, yielding a cumulative survival rate of 91.1% over a median survival time of 312 months. Implants supporting cement-retained prostheses exhibithed lower survival rate compared to screw-retained restorations (p = 0.001).Conclusion
Implants placed in bone augmented with iliac crest onlay grafts showed high long-term survival rates. Cement-retained restorations were more prone to develop implant failures. 相似文献8.
Mark A. Saxen Douglas E. Peterson Michael Mashni 《Journal of the American Dental Association (1939)》2019,150(3):193-199
Background
Specialty-based practice is a fundamental component of US medicine and dentistry, yet the recognition of new dental specialties has markedly diminished in the past 50 years while medical specialization has flourished.Methods
This article reviews the history of specialty development while focusing on the underlying scientific, educational, and cultural changes in both professions. The process of dental specialty recognition is also examined.Results
The current dental specialty recognition process provides a set of criteria aspiring specialties need to fulfill at the time of application, yet the relationship between the criteria and the sequence for attaining them is undefined. Scientific development and evidence-based practice have grown to become the cornerstone of contemporary health care specialization.Conclusions
A new paradigm for specialty and subspecialty development in dentistry is needed. A model is presented herein that recognizes scientific development as the basis for specialization and describes a formal, sequenced process for the development of emerging specialties and subspecialties.Practical Implications
This new paradigm for dental specialty recognition builds on the current criteria for specialization while encouraging cross-disciplinary interaction and nurturing the development of emerging specialties and subspecialties in dentistry. Doing so will allow dentistry to maintain its lead role in the maintenance of oral health and oral disease treatment in the US population. 相似文献9.
Priscilla Medina-Sotomayor Agustín Pascual-Moscardo Isabel Camps A 《The Journal of prosthetic dentistry》2019,121(5):811-820
Statement of problem
The accuracy of digital scanners is acceptable for scanning a complete dental arch. However, whether that accuracy is sufficient for only 1 tooth within the dental scan of a complete dental arch is unclear.Purpose
The purpose of this in vitro study was to evaluate and compare the accuracy of 4 intraoral scanners on a complete dental arch and on prepared teeth digitally isolated from the digital scan in terms of trueness and precision.Material and methods
A model of a complete dental arch with tooth preparations was scanned 40 times with each of the 4 digital scanners. Their accuracy was evaluated by using 3-dimensional (3D) software to compare the test models with a highly accurate reference model. The data were digitally processed to isolate the prepared teeth and evaluate them in the same way. The data were statistically analyzed using the Levene test and the Tamhane's T2 test (α=.05).Results
In scans of a complete dental arch, the True Definition scanner had the best accuracy values, followed by TRIOS, iTero, and Omnicam. For prepared teeth isolated from the dental arch, both True Definition and TRIOS had the best values, followed by iTero and Omnicam.Conclusions
In both long-span scans of the complete dental arch and isolated prepared teeth, the True Definition scanner had the greatest accuracy, closely followed by TRIOS. 相似文献10.
11.
Sameh Attia Joerg Wiltfang Jörn Pons-Kühnemann Jan-Falco Wilbrand Philipp Streckbein Christopher Kähling Hans-Peter Howaldt Heidrun Schaaf 《Journal of cranio-maxillo-facial surgery》2018,46(8):1205-1210
Purpose
Ablative oncological surgery to treat head-and-neck cancer often triggers a requirement for jaw reconstruction. Modern surgical procedures using free microvascular flaps afford acceptable outcomes in terms of restoration of bony and soft tissue defects. A fibula free flap is often the preferred flap, as the bone length is considerable and a two-surgeon approach is possible. Dental implants play important roles in functional rehabilitation. Our aim was to evaluate the survival of dental implants placed in reconstructed areas after transfer of fibula tissue to the jaw.Materials and methods
We retrospectively studied 34 patients who underwent ablative tumour surgery and jaw reconstruction using osteocutaneous fibula free flaps and who then received dental implants. We evaluated implant survival and success, survival of the fibula flap, and clinical and radiographic data.Results
We included 34 patients, 23 of whom were diagnosed with squamous cell carcinoma. In total, 134 dental implants were inserted in transferred fibula bone. The cumulative implant survival rate was 81%. The survival rate of the 34 fibula flaps transplanted after surgical reconstruction was 97%.Conclusion
The insertion of endosseous implants after jaw reconstruction using vascularised fibula tissue yields successful dental rehabilitation in patients with oral cancers. 相似文献12.
Mohammed Nadeem Ahmed Bijle Manikandan Ekambaram Edward C.M. Lo Cynthia Kar Yung Yiu 《Journal of Evidence》2019,19(1):28-33
Background
Several significant issues on clinical trials reporting the effect of arginine-containing dental products have been addressed in systematic reviews and meta-analyses identifying the need for high-quality randomized clinical trials. A further methodological analysis of the given systematic reviews with meta-analysis on arginine products might provide information for future high-quality randomized clinical trials and current clinical practice.Objective(s)
The objective was to perform a meta-epidemiological assessment of meta-analyses reporting the anticaries effect of arginine-containing formulations.Methods
The data on risk-of-bias assessment, effect size measure, dispersion of estimated precision, and follow-up period were summarized for the meta-epidemiological review analysis.Results
Studies with larger magnitude of effect sizes might present with unclear random sequence generation and unclear allocation concealment representing the selection bias. There was a significant strong negative correlation between the follow-up time and dispersion of precision estimates (rs = ?0.79, P = .034).Conclusion
Results show that clinical trials on arginine dental products have methodological shortcomings. Both the selection bias and follow-up period influence the effect size magnitude and subsequent precision dispersion during evidence synthesis in clinical trials on arginine-containing dental products. 相似文献13.
Oral Cenk Aktas Wolfgang Metzger Ayman Haidar Yahya Açil Aydin Gülses Jörg Wiltfang Catharina Marques Sacramento Frank Philipp Nothdurft 《Journal of cranio-maxillo-facial surgery》2019,47(4):661-667
Background
Promoting the directional attachment of gingiva to the dental implant leads to the formation of tight connective tissue which acts as a seal against the penetration of oral bacteria. Such a directional growth is mostly governed by the surface texture.Material and methods
In this study, three different methods, mechanical structuring, chemical etching and laser treatment, have been explored for their applicability in promoting cellular attachment and alignment of human primary gingival fibroblasts (HGFIBs).Results
The effectiveness of mechanical structuring was shown as a simple and a cost-effective method to create patterns to align HGIFIBs.Conclusion
Combining mechanical structuring with chemical etching enhanced both cellular attachment and the cellular alignment. 相似文献14.
S.E.C.M. van de Vijfeijken R. Schreurs L. Dubois A.G. Becking 《Journal of cranio-maxillo-facial surgery》2019,47(4):542-547
Purpose
The aim of this study was to evaluate the accuracy of resection templates in cranioplasties in order to facilitate a one-stage resection and cranial reconstruction. Patients and methods: In three cases, cranial resections were combined with direct reconstructions using the principles of computer-aided design, manufacturing, and surgery. The precision of the resection template was evaluated through a distance map, comparing the planned and final result.Results
The mean absolute difference between the planned and actual reconstructed contour was less than 1.0 mm. After 3 years, no clinical signs of infection or rejection of the implants were present. The computed tomography scans showed no irregularities, and the aesthetic results remained satisfactory.Conclusion
One-stage resection and cranial reconstruction using a resection template, control template, and a prefabricated patient-specific implant of poly(ether-ether-ketone) (PEEK) proved to be a viable and safe method. 相似文献15.
Carolin Goetz Nora-Maria Burian Jochen Weitz Klaus-Dietrich Wolff Oliver Bissinger 《Journal of cranio-maxillo-facial surgery》2019,47(4):642-646
Background
Temporary tracheotomies are often used in oral microvascular flap reconstruction surgery to secure postoperative airway management and avoid emergency tracheotomies. Even when planned electively, a tracheotomy can cause severe and life-threatening complications. The aim of this study was to evaluate the complications of tracheotomies performed on oral cancer patients with microvascular flap reconstructions and differentiated patterns, which could lead to postoperative complications.Methods
150 patients, treated in the Department of Oral and Maxillofacial Surgery from March 2017 to August 2018, were included in this study. Patient records and perioperative data were analysed and the following specific items were evaluated: time after surgery until removal of the tracheal cannula, complications, cause and point of time of reinsertion of the cannula, anticoagulative treatment, ASA grade (American Society of Anaesthesiologists), TNM stage, and patient-specific data.Results
30 patients (20%) developed tracheotomy-associated complications, most commonly pneumonia (50%). There was a significant correlation between the time period until removal of the cannula and the occurrence of complications such as pneumonia and bleeding.Conclusion
The results of our study lead us to recommend continuing to perform temporary tracheotomies in oral cancer surgery with microvascular flap reconstruction. The overall complication rate is low and postoperative airway management can be performed in a safe and controlled manner. Nevertheless, the time period for the inserted cannula should be kept as short as possible. 相似文献16.
Theodore V. Tso Martina Hurwitz Danielle N. Margalit Sang J. Lee Christopher L. Williams Evan B. Rosen 《The Journal of prosthetic dentistry》2019,121(4):703-707
Statement of problem
Electron backscatter radiation from dental materials can contribute to soft tissue injury in patients undergoing head and neck radiation therapy.Purpose
The dose enhancement from the materials used for prosthodontic restoration of the dentition has not been well quantified. This study reports the magnitude of backscatter dose from the contemporary dental materials lithium disilicate and zirconia as compared with high-noble alloy and investigates the role of a spacer material in mitigating this effect.Material and methods
Three flat slabs of dental materials high-noble alloy, lithium disilicate, and zirconia with thicknesses of 1.5 and 3 mm were irradiated with 6-MV photons from a clinical linear accelerator. Measurements were made using a thin-window parallel-plate ionization chamber placed at 0, 1, 3, and 5 mm from the material. One millimeter of poly(methyl methacrylate) or thermoplastic material was used to cover the dental material and measure the effect on the adjacent dose enhancement.Results
Dose enhancements between 8% and 50% were recorded adjacent to the dental restoration materials. The largest enhancements occurred for the material of the highest density, the high-noble alloy. Dose enhancement was substantially lower for lithium disilicate (8%) and zirconia (30%). The thickness of the restoration material did not significantly affect dose enhancement. The dose enhancement decreased with distance from the material, dropping to <10% for all materials at 3 mm.Conclusions
Contemporary dental restorations enhance the backscatter dose. The presence of dental restorations may warrant the use of a stent to create separation from these materials as this can mitigate the effect. 相似文献17.
Lydie A. Lebrun-Harris María Teresa Canto Pamella Vodicka 《Journal of the American Dental Association (1939)》2019,150(4):246-258
Background
Research has identified significant gaps in preventive oral health care among certain subpopulations of US children. The authors of this study sought to estimate children’s preventive oral health care use and oral health and investigate associations with child, family, and health care characteristics.Methods
Data for this observational, cross-sectional study came from the 2016 National Survey of Children’s Health. Children aged 2 through 17 years were included (n = 46,100). Caregiver-reported measures were preventive dental visits, prophylaxis, toothbrushing or oral health care instructions, fluoride, sealants, fair or poor condition of the teeth, and problems with carious teeth or caries. Univariate, bivariate, and multivariable logistic regression analyses were conducted.Results
As reported by parents or caregivers, 8 in 10 children had a preventive dental visit in the past year but lower rates of specific services: 75% prophylaxis, 46% fluoride, 44% instructions, and 21% sealants. In addition, 12% had carious teeth or caries and 6% had fair or poor condition of the teeth. In adjusted analyses, young children (aged 2-5 years), children with no health insurance, and those from lower-income and lower-educated households had decreased likelihood of a preventive dental visit as well as specific preventive services. Children with preventive health care visits and a personal physician or nurse had increased likelihood of receiving preventive oral health care.Conclusions
Preventive oral health services are lagging among young children and children from lower socioeconomic backgrounds. Further studies are needed to identify interventions that encourage use of specific preventive services.Practical Implications
Dentists should work with caregivers and primary care providers to promote preventive oral health care, especially among young children and those from lower socioeconomic backgrounds. 相似文献18.
Paul Weigl Georgia Trimpou Jonas Lorenz Georg-Hubertus Nentwig Hans-Christoph Lauer 《The Journal of prosthetic dentistry》2019,121(4):618-622
Statement of problem
Nonrigid retainer systems for removable implant superstructures are associated with negative effects such as rocking and increased load on the denture base. Rigid retainer systems such as telescopic crowns reduce these negative effects, but their fabrication demands highly skilled dental technicians and is therefore expensive. Whether a protocol with prefabricated retainers will reduce production time is unclear.Purpose
The purpose of this prospective clinical trial was to evaluate a prefabricated telescopic retainer and a treatment protocol including the intraoral luting of a framework.Material and methods
A total of 23 participants (15 women and 8 men with a mean age of 61.6 ±2.9 years) were included. After 3 dropouts, 21 removable dentures (9 mandibular and 12 maxillary) retained by 91 delayed loaded Ankylos implants were investigated. All implants were restored with prefabricated conically shaped abutments (SynCone-abutment). The prefabricated corresponding cone matrix was assembled intraorally into a metal frame with autopolymerizing resin. After a loading period of 3 years, a follow-up examination investigated the fit of the framework, the prosthetic aftercare, the technical failures, and the retention force. A questionnaire was used to evaluate participant satisfaction. In addition, laboratory fabrication time and costs were compared with those of individually fabricated restorations.Results
One mandibular implant was lost after 25 months (survival rate, 98.9%). The removable dentures showed no apparent rocking and minimal prosthetic maintenance during the 36-month trial. No dentures required relining. The retention force was scored as good in 17 participants and high (with 6 implants in the maxilla) and low (with 2 implants in the mandible) in 2 participants each. No technical failures occurred. An assessment of laboratory fabrication time and costs revealed reduced time and costs. Patient satisfaction was significantly increased (P<.001) over the entire observation time.Conclusions
The SynCone retainer presented a time- and cost-efficient treatment option with sufficient long-term retention for removable dentures and high patient satisfaction. Mandibular prostheses restored with 2 implants had limited success. 相似文献19.
Hendrik Naujokat Sönke Harder Lara Yasemin Schulz Jörg Wiltfang Christian Flörke Yahya Açil 《Journal of cranio-maxillo-facial surgery》2019,47(3):484-490
Purpose
Successful implant therapy is based on fast, safe, and predictable osseointegration. Several surface modifications have been introduced to improve the bone-to-implant interaction. This in vivo study evaluates the impact of plasma surface conditioning on early wound healing and osseointegration.Materials and methods
A total of 16 dental implants with a sand-blasted and acid-etched surface were conditioned with cold atmospheric plasma prior to insertion in the frontal bone of four miniature pigs. Sequential fluorescence labeling was administered to label bone metabolism, and after 8 weeks, bone blocks were harvested for radiological, histological, and histomorphometrical evaluation.Results
The plasma conditioning had no impact on the morphology of the implant surface. The bone-to-implant contact ratio was 90.4% and 86.5%, the interthread bone density 72.5% and 63.4%, and the periimplant bone density 60.5% and 61.1%, in the plasma conditioned group and control group, respectively. Concentric bands of fluorescence enrichment indicated a chronological and homogenous mineralization of newly formed bone. No unwanted periimplant side effects were detected.Conclusion
The increased parameters for osseointegration in this in vivo study merit further investigation in prospective clinical trials. 相似文献20.
William Riley Mark Doherty Kailey Love 《Journal of the American Dental Association (1939)》2019,150(3):178-185